Grant Assistance for Grassroots Human Security Projects (GGP)

PROJECT CONCEPT NOTE 2018 Grant Assistance for Grassroots Human Security Projects (GGP)

1. Basic Information of Organization 1. Name 2. Office Address 3. Telephone number 4. 1st Alternative contact 5. 2nd Alternative contact 6. Fax number 7. Email address 8. Representative of Organization/Title 9. Name of Contact Person/Project Officer 10. Number of staffs 11. Year of registration /number, country

2. Experience of Organization (1) Main activities (Type of Activity, implemented place and year). Please give 2 to 3 examples.

Donor Year Amount Activities*

(2) History of cooperation with other donors *Please include information of target geographical area, specifying district and province.

(3) Stable financial resources to Yes cover administrative and Amount per year: running costs of the organization (staff salaries, Source: electricity, rent, paper, faxes, fuel etc.) No Yes (4) Has your organization applied Year: Sector: for the GGP before? If yes, please give the applied year, Name of sector and the name of the the project: project. No

3. Proposed Project Information (1) Project Name (2) Project Category Education Health Water & Sanitation Others ( ) (3) Project Site Province: District: Administration Post: Locality: (4) Project Contents and Proposed Activities (5) Background, actual situation and the reason why the project is necessary (6) Expected Effects/Results (7) Expected number of Direct: Indirect: beneficiaries (8) Proposed Budget Item Quantity Estimated Price (USD)

*External Audit is necessary to be executed when the total budget exceeds 3 million Japanese Yen. Total

(9) Proposed Project Duration (Maximum 1 year) (10) Similar project experience in the sector (11) Any additional information, if necessary

4. Signature of Organization Representative Name Title Signature ______Date

For More Information Embassy of Japan Av. Julius Nyerere 2832, Maputo P.O. Box 2494 Tel: (21) 499819/20 Fax: (21) 498957 Contact person: Ms. Akiko Shimohira ou Ms. Káttia Carlos Email: akiko.shimohira @mp.mofa.go.jp ou [email protected]